Cardiovascular
Ian Mann, Alastair Noyce in The Finalist’s Guide to Passing the OSCE, 2021
Patient position is crucial to the cardiovascular examination. The ideal position is with the patient semi-recumbent at 45°. Three or four peripheral signs should suffice. It is more important to make the people examination of the hands purposeful and structured, so that they acknowledge signs, if indeed they are present. One should compare sides for radial–radial delay, and also at the groin for radial–femoral delay. Eyes should be checked for: corneal arcus, xanthelasma and pallor of the conjunctiva. The carotid pulses should be palpated one side at a time. It may be easier to pass comment on pulse character and volume from central position. Examination of the jugular venous pulsation should begin by ensuring that the patient is reclined at 45°. There is little to percuss in the cardiovascular examination. It is particularly important to auscultate the lung bases and listen for the characteristic crackles of pulmonary oedema.
Xanthelasma
Charles Theisler in Adjuvant Medical Care, 2022
Xanthelasma is a localized deposit of fat and cholesterol near the inner canthus of the eyelid. Xanthelasmas appear as a yellowish, raised plaque, more often on the upper lid than on the lower lid. Some xanthelasmas can be indicative of hyperlipidemia that can be associated with increased risk of coronary heart disease or occasionally with pan-creatitis (due to hypertriglyceridemia). About half the people with xanthelasma have high cholesterol. These patches will not go away on their own and may grow in size. Removal, although not without some unwanted side effects, may be the best option, but the growths can come back.
Operative Treatment of Large Periocular Xanthelasma
Published in Orbit, 2009
Biljana Kuzmanović Elabjer, Mladen Bušić, Sandra Sekelj, Edita Kondža Krstonijević
Purpose: To present our experience in operative treatment of large periocular xanthelasma. Methods: Sixty-three patients with large periocular xanthelasma were operatively treated in our department. Ipsilateral and/or contralateral lid skin grafts harvested by blepharoplasty, alone or in combination with local flaps, were used. Forty patients (64%) had enough skin to graft the defect after primary xanthelasma removal. In 10 patients, additional local flaps were used: modified rhomboid flap in six patients, local advancement flap in two, and bi-lobed flap in two patients. In three patients (5%), a sequential approach was applied since xanthelasma were too large to be completely removed in a single-step excision. No serious complications were shown. Results: Patients were followed from 6 months to 8 years. Five patients (8%) returned with recurrences 3–8 years after primary excision. Conclusions: In lack of the setting for xanthelasma laser treatment, operative approach of a single-step or sequential excision using lid skin graft combined with local flaps proved its value for large periocular xanthelasma.
Influence of low-level laser on pain and inflammation in type 2 diabetes mellitus with diabetic dermopathy – A case report
Published in Journal of Cosmetic and Laser Therapy, 2017
Animesh Hazari, Shivashankara K. N, Karthik K. Rao, Arun G. Maiya
Numerous skin lesions have been commonly observed in individuals with diabetes mellitus. The common skin manifestations of diabetes mellitus are erythrasma, xanthomatosis, xanthelasma, phycomycetes and cutaneous infections like furuncolosis, candidiasis, carbuncle, dermatophytosis, etc. Diabetic dermopathy is the most common skin lesion found in patients with diabetes. It is typically seen in men aged above 50 years. In low-level laser therapy (LLLT), the entire lower limb was illuminated with the frequency of 20 Hz and wavelength of 830 nm for 9 min, and the treatment was divided into four parts. With the continued sessions of LLLT, the skin manifestations and neuropathy conditions improved drastically. On the 21st day, the skin colour was found to be normal. Also, there were significant changes in clinical findings for diabetic peripheral neuropathy. LLLT with specific exercises can promote healing of skin manifestations in individuals with type 2 diabetes mellitus. It can be used as an effective treatment modality for treating diabetic dermopathy.
Erbium: YAG laser ablation versus 70% trichloroacetıc acid application in the treatment of xanthelasma palpebrarum
Published in Journal of Dermatological Treatment, 2014
Şule Güngör, Dilek Canat, Gonca Gökdemir
Background: Xanthelasma palpebrarum (XP) is characterized by soft, yellow plaques on the upper or lower eyelids that create aesthetic problems for patients. There are several methods in the treatment of XP, such as surgical excision, blepharoplasty, cryotherapy, electrocauterization, chemical cauterization using trichloroacetic acid (TCA) or bichloroacetic acid and laser ablation. Objective: To evaluate the efficiency and complications of 70% TCA application versus erbium: YAG laser ablation in different XP lesions on the same patient. Methods: A total of 21 patients were taken into the study—1 male and 20 females, from ages 22 to 70 years. Erbium: YAG laser ablation and 70% TCA application were performed in different XP lesions of the same patient. All patients were photographed before initiating treatment and after 4 weeks using the same digital camera. Evaluation was performed 4 weeks after the first treatment session by comparing pre-treatment and post-treatment photographs by two independent dermatologists. Results: No significant difference of the improvement scores between the erbium laser and TCA was found (p = 0.248). No significant difference between the complication scores using erbium laser and TCA was found (p = 0.739). Conclusions: Both 70% TCA application and erbium: YAG laser ablation methods have similar effectiveness and complication rates.